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Health Insurance as a Means for Health Development (Asuransi Kesehatan : Salah Satu Alat untuk Mendukung Pembangunan Kesehatan Nasional)
Health care systems worldwide are in a stage of transition, in some countries even in crisis. The main underlying causes are universal : economic constraints on one side, versus population pressures on the other. It is an issue of growing disparity between limited resources and increasing demands and needs. Many governments, the Indonesian goverment included, are implementing strategies for developing resources and containing health care costs. The community and the private sector are encouraged to participate in health care financing. Mechanisms for participation by those non-government sectors will be discussed, which are : 1. User charges or user fees, on which the Indonesian concept of Rumah Sakit Swadana is based. 2. Community financing, citing the Dana Sehat experience of villages in Java and Bali. 3. Private sector participation in the development of the health care industry. 4. Health insurance, with short comment on the Indonesian managed care concept of JPKM. Both the strong points and potential drawbacks of each mechanism will be discussed, with special emphasis on health insurance. It will also be stressed that JPKM is not a matter of health financing only; it is an effort to integrate financinf and the substance of health care itself, with the objective of improving the health status of the nation as a whole. However, legal controversies are still hampering the development of JPKM.
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